Provider Demographics
NPI:1396993747
Name:FIRST CHOICE OF NORTH CAROLINA
Entity type:Organization
Organization Name:FIRST CHOICE OF NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIPHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-222-9209
Mailing Address - Street 1:2832 OLD IRONSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4089
Mailing Address - Country:US
Mailing Address - Phone:704-222-9209
Mailing Address - Fax:
Practice Address - Street 1:2832 OLD IRONSIDE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4089
Practice Address - Country:US
Practice Address - Phone:704-222-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child